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Effects of Distraction on Pain, Fear, and Distress During Venous Port Access and Venipuncture in Children and Adolescents With Cancer

Department of Radiology at Children's Medical Center Dallas, Dallas, TX Andrea.Biermeier{at}childrens.com

Isabelle Sjoberg, RN, BSN

Children's Hospital of Eastern Ontario, Ottawa

Juanita Conkin Dale, RN, PhD, CPNP

Debra Eshelman, RN, MSN, CPNP

Center for Cancer and Blood Disorders at Children's Medical Center Dallas

Cathie E. Guzzetta, RN, PhD, AHN-BC, FAAN

Holistic Nursing Consultants, Washington, DC

This study evaluates the effect of self-selected distracters (ie, bubbles, I Spy: Super Challenger book, music table, virtual reality glasses, or handheld video games) on pain, fear, and distress in 50 children and adolescents with cancer, ages 5 to 18, with port access or venipuncture. Using an intervention-comparison group design, participants were randomized to the comparison group (n = 28) to receive standard care or intervention group (n = 22) to receive distraction plus standard care. All participants rated their pain and fear, parents rated participant fear, and the nurse rated participant fear and distress at 3 points in time: before, during, and after port access or venipuncture. Results show that self-reported pain and fear were significantly correlated (P = .01) within treatment groups but not significantly different between groups. Intervention participants demonstrated significantly less fear (P <.001) and distress (P = .03) as rated by the nurse and approached significantly less fear (P = .07) as rated by the parent. All intervention parents said the needlestick was better because of the distracter. The authors conclude that distraction has the potential to reduce fear and distress during port access and venipuncture.

Key Words: distraction • procedure-related pain • cognitive-behavioral interventions • pediatric oncology patients

Journal of Pediatric Oncology Nursing, Vol. 24, No. 1, 8-19 (2007)
DOI: 10.1177/1043454206296018


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